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Right now, there is no good evidence that gabapentin can be used for treating people with bipolar disorder. High-quality, randomized controlled studies found that gabapentin was not dence for gabapentin’s efficacy in bipolar disorder and the FDA has approved lamotrigine for the treat-ment of bipolar disorder.1,2 Thus, up to half of bipolar patients receiving combination therapy are given anti-convulsants (such as gabapentin or topiramate) that are not well docu-mented to work for bipolar disorder. 1–3 Why? While some case series and open-label studies have provided evidence of efficacy of gabapentin for bipolar disorder, four RCTs assessing treatment efficacy for nonspecific overall symptom severity, as well as more specific symptoms of mania, hypomania, and mixed state, have failed to support the use of gabapentin for bipolar disorder. 5 For Despite of the lack of evidence, reviews of gabapentin prescribing patterns in the United States show that this medication is still being used with alarming frequency for bipolar disorder. There are now five medications with specific, FDA approval for acute bipolar depression. Gabapentin has an average rating of 8.5 out of 10 from a total of 138 reviews for the off-label treatment of Bipolar Disorder. 81% of reviewers reported a positive experience, while 9% reported a negative experience. An open trial of pregabalin as an acute and maintenance adjunctive treatment for outpatients with treatment resistant bipolar disorder. J Affect Disord. 2013;147:407–10. Article CAS PubMed The use of gabapentin in bipolar disorder (BPD) treatment provides an informative case of off-label uptake and abandonment of a new medication. Gabapentin was patented by Warner-Lambert in 1977 and FDA-approved in December1993 for the adjunctive treatment of epilepsy and in 2002 for postherpetic neuralgia (see Appendix 1 for timeline). After receiving gabapentin 600–3,600 mg/d for 10 weeks, mood scale scores were no different between treatment groups. 19 In a double-blind, randomized, crossover series (N = 31), 20 patients with refractory bipolar and unipolar mood disorder received three 6-week monotherapy treatments of lamotrigine, gabapentin, or placebo. Results: Gabapentin was moderately to mark-edly effective in 30% (15/50) of patients, with statistically nonsignificant differences between patients with bipolar disorder type I, bipolar dis-order type II and NOS, and unipolar major de-pressive disorder. 70% reported side effects, mainly sedation, with 16% of the total sample discontinuing treat Stanton et al.7 described a successful treatment of acute mania with gabapentin (at 3600 mg/day) mono-therapy in a 40-year-old man with DSM-IV bipolar I dis-order and alcohol dependence. Gabapentin may be a useful drug for the add-on treatment of bipolar patients with poor response to other mood stabilizers. Gabapentin may improve depressive residual symptoms such as irritability, social withdrawal or anxiety. For the acute treatment of BD, our primary outcome was the efficacy of gabapentin or pregabalin as measured by the following: (i) number of hospital admissions during the study period, (ii) length of hospital admission, (iii) change on validated manic or depressive symptom rating scales from baseline, (iv) change on validated psychotic symptom Gabapentin is currently being studied as a treatment for bipolar disorder, and there have been favorable reports regarding its potential as a mood stabilizer (82, 83). The advantages of gabapentin include the lack of interactions with other drugs in the cytochrome P450 system and the lack of protein binding ( 84 ). Despite previous marketing claims, there’s no evidence that gabapentin is a useful treatment for bipolar disorder. The best treatment for bipolar disorder is a combination of other medications, including mood stabilizers, anticonvulsants, and antipsychotics. Adjunctive Gabapentin treatment of bipolar disorder. Eur. Psychiatry, 15 (2000), pp. 433-437. View PDF View article Crossref View in Scopus Google Scholar. Yasmin, 2000. Abstract. Despite its prevalence and disease burden, several chasms still exist with regard to the pharmacotherapy of bipolar disorder (BD). Polypharmacy is commonly encountered as a significant proportion of patients remain symptomatic, and the management of the depressive phase of the illness is a particular challenge. With safety, efficacy, and a proposed mechanism well-established for treating neuropathic pain and seizure, 2 – 5, 10 – 13, 16 numerous case reports and reviews suggest gabapentin’s potential efficacy as either monotherapy or adjunctive therapy in the treatment of bipolar disorder, depression, anxiety disorders, posttraumatic stress Background: Gabapentin, a new anti-epileptic agent, has been anecdotally reported to be effective in the treatment of mania. We systematically assessed the response rate in bipolar patients being treated adjunctively with gabapentin for manic symptoms, depressive symptoms, or rapid cycling not responsive to standard treatments. Gabapentin may be a useful drug for the add-on treatment of bipolar patients with poor response to other mood stabilizers. Gabapentin may improve depressive residual symptoms such as irritability, social withdrawal or anxiety. These results should be confirmed in randomized clinical trials. Background: with increasing awareness of lithium's limitations, several new anticonvulsants had been tested for their mood stabilisation during recent years. Among the innovative third generation mood stabilizing anticonvulsants, gabapentin (GBP) seems to have a broad spectrum of efficacy, although no certain data are available as to its efficacy and use in clinical practice.
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